HOMEFIRST FALLS PREVENTION TRIAL

1. HOMEFIRST FALLS PREVENTION TRIAL LEESA HOUSTON SENIOR HEALTH PROMOTION OFFICER & YVONNE CARSON SENIOR HEALTH PROMOTION OFFICER

2. THE PROBLEM OF FALLS • Falls represent the most frequent and serious type of accident in the over 65 age group (Help The Aged 2003)

3. Falls are the most common reason for admission to residential care (Help The Aged 2003)

4. PROJECT OUTLINE • Consultation with senior management • Identified Pinewood Residential Home Ballymena, John McAuley (Manager) and Lisgarel Residential Home Larne, Andrew Jamison (Manager) • Project to last 3 months • 10-12 clients at high risk of falling identified, consented to participate in the project

5. AIMS OF THE FALLS PREVENTION TRIAL • To use a multi-faceted approach to Falls Prevention within 2 Homefirst Residential Homes • To raise awareness amongst staff of the risk factors for falls

6. A multi-faceted approach to Falls Prevention was adopted as recommended by the NICE Guidelines (2004) (National Institute for Clinical Excellence)

7. COMPONENTS OF THE MULTI-FACETED APPROACH • The Introduction of a Falls Risk Assessment Screening Tool • Falls Prevention Training for Staff • Medication Review • Eyesight Assessment • Tai Chi

8. COMPONENTS OF THE MULTI-FACETED APPROACH CONT. • Foot Care Training and Referral to Podiatry • The use of Hip Protectors • Provision of Home Safety Aids • Poster Presentation

9. THE FALLS RISK ASSESSMENT SCREENING TOOL • It is used to identify older persons at risk of falling • Devised by A Regional Group of Physiotherapists and Occupational Therapists

10. CRITERIA USED IN THE TOOL • Age • Gender • History of falls • Present level of functional mobility • Balance • Footwear • Visual problem identified • Medications • Mental State

11. FALLS PREVENTION TRAINING FOR STAFF • In House • The aim of the training was to raise awareness of the risk factors for falls and offer a multi-factorial approach to preventing falls

12. MEDICATION REVIEW • Bairds Chemist in Ballymena • McFarlanes Chemist in Larne • With a view to reviewing the participating clients’ medication and replacing or withdrawing those medicines which increased the risk of falling

13. EYESIGHT ASSESSMENT • Free eye tests were carried out by Optomise

14. TAI CHI • Tai Chi promotes strength and increased flexibility of the muscles and joints, as well as improved balance in clients who are at risk of falling

15. Body Health (Terence and Isabel Barnes) • 12 week Tai Chi Course • In both homes • With the identified clients • Each session to last 1 hour • 2 or 3 staff from each home were selected to participate in Tai Chi Leaders Training • The staff received 12 X 30 minute training sessions

16. * The Tai Chi exercises used in the trial were specifically developed for use in these homes and in relation to the Falls Prevention Programme

17. FOOT CARE TRAINING AND REFERRAL TO PODIATRY • Staff each received a 45 minute basic foot care awareness training session from Paul Hutchinson (Homefirst Podiatrist) • Referrals to Homefirst Podiatry were made where necessary

18. THE USE OF HIP PROTECTORS • Hip Protectors are designed to help prevent hip fractures for those at risk of falling • Hip Protectors were supplied to each home for use with clients who were at high risk of falling • Training in how to use them by Safehip representative

19. PROVISION OF HOME SAFETY AIDS • Touch Lamps • Long-handled shoe horns

20. POSTER PRESENTATION • Aim was to involve family and friends of clients to generate an overall interest and awareness of falls prevention issues.

21. RESULTS • Both homes have started to use the Falls Risk Assessment Screening Tool for all newly admitted clients • There is a need for improved recording and reporting of falls

22. RESULTS CONT. • Medicines management and eyesight assessment are two systems that work well in the homes • Both homes found Tai Chi innovative and enjoyable. Clients benefited in terms of improved strength, balance and mobility when they attended all the sessions.

23. RESULTS CONT. • Apart from improvements in mobility one manager commented on the social enjoyment aspect, story telling aspect – very therapeutic • 4 members of staff achieved their Leaders Certificate • 32 staff were trained in falls prevention and evaluation following the training was positive • Many staff were unable to attend the training sessions

24. RECOMMENDATIONS • More training on the Falls Risk Assessment Tool • Clearer definition of what constitutes a fall • Further work recording falls • Tai Chi offered in other units • In order to benefit from Tai Chi clients must attend the sessions as frequently as possible

25. RECOMMENDATIONS CONT. • Bodyhealth noted that for future projects initial selection of staff to be trained as Leaders in Tai Chi is of great importance • Falls prevention training should be carried out annually • Member of staff trained up in Falls Prevention issues in each home.

26. CONCLUSION • At the end of the project both managers felt the trial had been worthwhile and that they had taken a positive approach to preventing falls within their homes.